MEDICAL RECORDS TECHNICIAN III

Full Job Description

This position is open ONLY to Colorado State Residents

The Medical Records Department (MR) manages health information for the benefit of the patient and care providers of the Colorado Mental Health Hospital at Pueblo (CMHHIP).

CMHHIP is a 516-bed psychiatric hospital with multi-specialty clinics serving the mentally ill and contracted agencies.

Medical Records scans documents into the electronic Medical Record (BEHR), monitors BEHR to ensure a complete and accurate medical record, and completes the census report accounting for every patient daily.

MR provides required psychiatric and clinic visit codes to identify all diagnoses treated to maintain diagnostic indices and maximize reimbursement from third party payers.

Medical records are audited for completion concurrently and upon discharge, coded and abstracted.

MR retrieves legacy medical records for use by authorized requestors, protects the confidentiality of protected health information by complying with all applicable state and federal laws, rules, and regulations.

Medical Records responds to all requests for records. Statistical databases are maintained for daily census, chart completion and also for quality measures that are reported to the Quality Council.

Provides professional service to customers with a positive attitude and will demonstrate behaviors that enhance working relationships and interactions with customers.

Displays behaviors that enhance the performance of the team (consensus building, pitching in when needed); make a contribution to building and maintaining a positive team atmosphere (acknowledging and reinforcing the contributions of others).

Requirements

Utilization Management Authorizations for Third Party Payer Reimbursement:

• This position will request and obtain all authorizations for third party payer insurance reimbursement, based upon medical necessity.
• Third party payers will include, but are not limited to Medicare, Medicaid, Tri-Care, and private insurance carriers.
• Will request authorizations each day by referring to the daily admissions list, and the third party payer form, and initiates the authorization process.
• Understands which patients are eligible for third party payer reimbursement, and all processes related to obtaining authorizations.
• Maintains a current contact list for each insurance carrier, and all departments/persons involved in utilization review.
• Submits appropriate medical record documentation to third party payers upon request and at established intervals.
• Performs appropriate follow-up for lack of response from the third party payers or others involved in the utilization review process.
• Independently problem-solves issues in the authorization request process, but understands when additional review is required.
• Maintains a tracking tool for authorization requests to minimize incidence of missing information or delay in submission of required documentation, or renewal of authorizations.
• Reports current authorization information or concerns to the Utilization Review Manager, weekly, at a minimum.
• Schedules clinical consultation meetings for provider/clinical team member with the insurance representative as needed.

Oversight of Medical Records Duties:

• This position both performs the following tasks and oversees the work of staff reporting to this position who have the primary responsibility for these duties.
• This position must have an in-depth understanding of the processes and regulations for all aspects of this duty.
• ROI/HIPAA /Patient information
  • Independently releases patient information to requesters per required HIPAA Federal Regulations.
  • Maintains release of information log, and documents all information released into Release of Information database.
  • Conducts interviews and determines the sanctions related to HIPAA violations.
  • Work with CDHS HIPAA Privacy and Security Officer to assist in modifying policies and procedures to incorporate OCR & CDHS HIPAA regulations.
  • Work with HIPAA Officer and management to mitigate Security and Privacy breaches and/or incidents.
  • Identify staff that has not completed mandatory CDHS HIPAA training related to violations and risk assessments.
  • Report all HIPAA violations and breaches to HIPAA Officer and Division Management.
• Chart Analysis
  • Completes audits using Google sheets audit form for; ECT, admissions, concurrent, outpatient, discharges, and deaths for compliance with all hospital policies, procedures and regulatory agency requirements.
  • Responsible for running the “Saved not Signed” and “Therapeutic Documentation” reports and notifying staff of documents needing to be signed.
  • Responsible for tracking various assessments and notes in the BEHR in accordance with CMS requirements.
  • Keep a record of due dates for RN and Social Work annual assessments, and send reminders to staff.
  • Requests death certificates for patients who are deceased.
  • Flags deficiencies in BEHR for providers.
    • Communicates deficiencies as appropriate.
• Abstracting/Scanning
  • Abstract data from charts to be reported to the Joint Commission, CMS, and ORYX.
  • Assures the accuracy of core measures for admission from the BH intake in BEHR.
  • Scan Suicide Precautions Level I (SPI), signature pages, and group tracker.
  • Maintains the Standard Operating Procedure (SOP) for abstracting and scanning.
• File Room
  • Must be familiar with BEHR, the electronic Health record, specifically Power Chart; Access HIM, and Revenue Cycle.
  • Pulls medical records for specific reviews: medical staff committees and audits by internal hospital committees.

  Prepares medical records for review by regulatory agencies such as: Joint Commission Pulls and prepares medical records for internal audits and reviews, such as: Quality, Infection Control, Physician audits, Peer Review, Pharmacy, and Patient Accounts, etc.

  Scan and Email previous Comp Evals to Court Services for the evaluators.

  • Files all records by terminal digit filing system, that have been completed by the treating staff and files all records back in the file room after all reviews.
  • Check charts out to doctors, admissions, and other clinicians on an as needed basis.
  • Completes the paper Medical Records Out guide and Request card. Checks the charts out in the chart tracking database and files the paper Medical Records Out guide and Request card in the tickler file.

  Checks the tickler file daily and calls for charts that are due back in the file room.

  Provides prompt friendly service to internal and external customers in a professional manner in the reception area of the department.

  Treats customers with respect and directs customers to appropriate locations if the customer needs assistance.

  • Pulls death charts and files them on the death shelf if paper record exists for that patient. Boxes death charts annually and takes them to storage. Must be able to physically load carts and boxes of charts for transport to reviews and to storage.
  • Is responsible for verifying the identifying information on documents to be scanned. Is responsible for scanning information in the correct patient, correct episode, and correct folder. Maintains Standard Operating Procedure document for scanning documents.

Supervision

• Supervises 2 full-time staff in the Medical Records Department.
• Uses judgment, creativity, and knowledge to interpret circumstances in a variety of situations and determine guidelines for implementation of resolutions.
• Coach and mentor staff within the department.
• Identify training needs and ensure staff is up to date on all training requirements.
• Ensure performance plans and evaluations are completed in a timely manner.
• Foster a cohesive team and positive work environment.
• Ensure employees have the tools they need to succeed in the department.
• This position starts the hiring process, interviews applicants, and recommends hire, promotion, or transfer. Delegates responsibilities to the operations team as needed to ensure all tasks are monitored and completed within expectations.

Other Duties as Assigned:

• Covers for Operations as needed. Answers phones and waits on walk in customers
• Scan documentation into BEHR as needed.
• Maintain death log

Qualifications

Minimum Qualifications:

Three (3) years of relevant experience in an occupation related to the work assigned to this position

OR

Education and Experience:

A combination of related education, certification, and/or relevant experience in an occupation related to the work assigned equal to three (3) years Certification related to the work assigned to the position will substitute for 2 (two) years of the required experience

Preferred Qualifications:

• Medical Records experience in a Hospital setting, (not outpatient, as in a Dr. office)

• Experience in Insurance billing/utilization review, health information management.

• Supervisory experience including performance management and evaluation.

• RHIT or RHIA

Conditions of Employment:

• Shall not initiate or engage in sexual, social, personal or financial relationships with patients either during or any time after hospitalization, even if the patient requests or initiates such a relationship. All relationships with current or former patients must be disclosed on your application;

• Successfully pass all modules of the CMHHIP New Employee Orientation core curriculum to include English reading comprehension, relevant competency assessments and written/practical exams;

• Ability to read and comprehend the English language; effectively and fluently communicates in English, both verbally and in writing;

• Work in situations involving assaultive behavior, physical control of another person and/or restraint situations

• Lift arms above head and kick as high as own waist;

• Stabilize another person to accomplish a controlled take down;

• Must be able to see and hear in order to observe, address and respond to potential breaches in safety;

• Seize, hold, control or subdue violent or assaultive persons and defend oneself or others to prevent injury;

• Demonstrate body agility, strength of all four limbs and the ability to walk and climb stairs consistently;

• Willing and able to travel;

• 2-step TB (tuberculosis) screening is required of all new employees upon hire;

• Annual influenza vaccination, other vaccinations as required by the State and facility.

CDHS Selection Process ExplanationEmployment history is calculated on a full-time basis (40/hrs per week). Part-time employment is calculated on a prorated basis to determine qualifications.

Be sure your application specifically addresses your qualifications, experience, work products, and accomplishments as they relate to the position and minimum requirements.

• Preferred Qualifications & Competencies:
  Relevant years of state service experience.

Minimum Qualification Screening Process A Human Resources Analyst will review the work experience/job duties sections of the online job application to determine whether your experience meets the minimum qualifications for the position.

You must complete the official State of Colorado online application. Cover letters and resumes WILL NOT be reviewed during the minimum qualifications screening process.

You must specifically document your work experience and qualifications. Do not use "see resume" or "see attached."You must meet the minimum qualifications to continue in the selection process.

Part-time work experience will be prorated.Comparative Analysis Process – Structured Application Review After minimum qualification screening, the comparative analysis process will involve a review and rating of all the information you submit.

The comparative analysis step may also include your results from an eSkills Test.

Your Work Experience/Job DutiesDocument your work experience/job duties to the extent to which you possess the skills, education, experience, minimum qualifications, and preferred qualifications.

Supplemental Questions Answer the supplemental questions completely and thoughtfully.

We will rate your answers based on the content of your response and your writing skills (spelling, grammar, and clarity of your writing).Appeal RightsYou may file an appeal with the State Personnel Board or request a review by the State Personnel Director if your application is eliminated.

You will find the appeals process, the official appeal form, and how to deliver it on the State Personnel Board website.You or your representative must sign and submit the official appeal form for review.

You can find the official appeal form here.

You must be deliver the official appeal form to the State Personnel Board:By email (dpa_state.personnelboard@state.co.us), orPostmarked in US Mail to(1525 Sherman Street, 4th Floor, Denver CO 80203, or Hand delivered (1525 Sherman Street, 4th Floor, Denver CO 80203), orFaxed (303.866.5038) within ten (10) calendar days from your receipt of notice or acknowledgement of the department’s action.Contact the State Personnel Board for assistance:At (303) 866-3300, or Refer to the Colorado Code of Regulations (CCR) 801-1, State Personnel Board Rules and Personnel Director's Administrative Procedures, Chapter 8, Resolution of Appeals and Disputes, within the Rules webpage.

Additional Information

How to apply to the State of Colorado

The Assessment Process

For additional recruiting questions, please contact: tricia.jepsen@state.co.us

About Us & Benefits:

If your goal is to build a career that makes a difference, join the dedicated people of the Colorado Department of Human Services (CDHS).

Our professionals strive to design and deliver high quality human and health services that improve the safety, independence, and well-being of the people of Colorado.

Each of us is committed to contributing to a safe and accessible CDHS. In addition to a great location and rewarding and meaningful work, we offer:

• Strong, secure, yet flexible retirement benefits including a PERA Defined Benefit Plan or PERA Defined Contribution Plan plus 401(k) and 457 plans

• Medical and dental health plans

• Employer supplemented Health Savings Account

• Paid life insurance

• Short- and long-term disability coverage

• 11 paid holidays per year plus vacation and sick leave

• State of Colorado Employee BenefitHub Resource Center

• Employee Wellness program

• Excellent work-life programs, such as flexible schedules, training and more

• Remote work arrangements for eligible positions

• Some positions may qualify for the Public Service Loan Forgiveness Program.

Our Values:

We believe in a people-first approach: We prioritize the needs, well-being, and dignity of the individuals, families and communities we serve.

We commit to respect, fairness and access in every decision, policy and interaction. We engage client voices and experiences in the development and implementation of the services we provide.

Balance creates quality of life: We want our team to be resilient through a supportive workplace that values flexibility, health and wellness, and employee engagement.

We hold ourselves accountable: We take responsibility through our actions, programs, and results for the state of health and human services in Colorado.

Transparency matters: We are open and honest with employees, our partners, the Coloradans we serve, and the public.

We are ethical: We abide by what is best for those we serve by doing what is right, not what is easy.

Collaboration helps us rise together: We work together with all partners, employees, and clients to achieve the best outcomes for Coloradans.

ADAA Accommodations:

CDHS is committed to a Colorado for ALL qualified individuals. As part of this commitment, our agency will assist individuals who have a disability with any reasonable accommodation requests related to employment.

This includes completing the application process, interviewing, completing any pre-employment testing, participating in the employee selection process, and/or performing essential job functions where the requested accommodation does not impose an undue hardship.

If you have a disability and require reasonable accommodation to ensure you have a positive experience applying or interviewing for this position, please direct your inquiries to cdhs_ada@state.co.us.

~THE STATE OF COLORADO IS AN EQUAL OPPORTUNITY EMPLOYER~

We are committed to increasing a “Colorado for ALL" of our staff and providing culturally responsive programs and services. Therefore, we encourage responses from people of all backgrounds and abilities. The State of Colorado believes that a “Colorado for ALL” drives our success, and we encourage candidates from all identities, backgrounds, and abilities to apply. The State of Colorado is an equal opportunity employer committed to building inclusive, innovative work environments with employees who reflect our communities and enthusiastically serve them. Therefore, in all aspects of the employment process, we provide employment opportunities to all qualified applicants without regard to race, color, religion, sex, disability, age, sexual orientation, gender identity or expression, pregnancy, medical condition related to pregnancy, creed, ancestry, national origin, marital status, genetic information, or military status (with preference given to military veterans), or any other protected status in accordance with applicable law.

~THE STATE OF COLORADO IS AN EQUAL OPPORTUNITY EMPLOYER~